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INFECTIOUS DISEASE SPECIALISTS – TRAVEL INFORMATION Prescription Medications -If you take prescription medications, you should consider taking a double supply. Transport and store these in separate places. Carry one supply with you and place the other in your luggage. Whether you do this depends on the medication and your destination. You are unlikely to have any problems if you are without a medication for high cholesterol for some time. However, abruptly stopping blood pressure medications, certain antidepressants, insulin, or other similarly critical medications may cause you to become ill. Underdeveloped locations may not have substitutes for medication that have been lost. Transport prescription medications in the original, pharmacy labeled bottles. When carrying prescription medications or insulin needles with you, it is advisable to have a letter from your travel-health care provider stating that you require these items for medical purposes. Contact Lenses -Bring a pair of glasses with you if you wear contact lenses. If signs of eye infection develop (redness, pain, or discharge), remove your contacts and seek medical attention. You should carry some antibiotic eye drops with you if you are in an area where you cannot get medical care. Allergic Reactions - Life-threatening allergic reactions are called “anaphylaxis.” Insect stings, certain foods, and some medications may trigger anaphylactic reactions. You should carry Epinephrine with you on your trip if you are known to have anaphylactic reactions. Common Travel Vaccinations - All of your childhood vaccinations should be competed before travel. You will be provided with a Vaccine Information Sheet, also know as a “VIS”, for any vaccines recommended today. This sheet explains the risks and benefits of the vaccination. The VIS also explains reasons why a person should NOT receive the vaccination. Some vaccines are “live” and rarely can cause disease. Individuals with suppressed immune systems from steroids, cancer, chemotherapy or other conditions cannot have certain vaccinations. Sometimes booster vaccinations may be needed. If so, we will mail you a reminder when they are due. Rabies - Rabies risks are higher abroad, especially in underdeveloped countries. Animal bites and bat exposures must be taken seriously. If an animal bites you, it is unlikely that you will be able to quarantine and observe the animal appropriately while abroad. Avoidance of animal contact is the best policy. If an animal bites you, you must obtain treatment locally or return to the US as soon as possible. Rabies vaccine is recommended for travelers with specific risk factors, such as those working directly with animals, or, for travelers who could not obtain rabies treatment if bitten. It is available to any risk-averse traveler who desires maximal pre-travel protection. Cholera Vaccine is not available in the US. It is not very effective and given only to relief workers traveling to a cholera outbreak. However, in some countries it is possible that “local officials” may require cholera vaccination. These local authorities may expect payment for vaccination and may not use proper sterile technique. You should not receive any vaccinations abroad unless you are certain that only sterile needles will be used. Re-use of needles may transmit HIV and other blood-borne illnesses. If necessary, your health care provider may stamp your vaccination certificate to make it appear that you have had cholera vaccination to avoid any non-sterile vaccinations abroad. Traveler’s Insurance - Medical evacuation in the event of life-threatening illness is extremely expensive. You should consider whether you wish to have travelers insurance that covers medical evacuation. We do not endorse any particular policy. You can get more information through a travel agent, your insurance agent or the internet. 1 Motion Sickness - If you anticipate being in a situation that will cause motion sickness or you are an individual who is prone to motion sickness, you may use over-the-counter medications available at your local pharmacy. If you have severe motion sickness, a prescription medication is available. Altitude Sickness - Traveling to high altitudes can cause mild or severe altitude illness. Serious symptoms usually do not occur below 9,000 to 10,000 feet above sea level. Symptoms can be mild or life-threatening. If you will be going to an altitude above 9,000 feet or if you have chronic lung disease that may result in altitude illness symptoms at lower elevations, you may take a drug called Acetazolamide or Diamox before your ascent in order to lessen the risk of altitude sickness. If you get severe altitude illness, you must descend until your symptoms begin to improve. Sexually Transmitted Diseases - Studies of travelers suggest that sexual contacts during travel are far more common than we realize. Remember that HIV/AIDS, Hepatitis B, Hepatitis C, Syphilis, Gonorrhea and other diseases are transmitted by blood and body fluids. Sexual contact without condom use and other highrisk activities such as tattoos, blood transfusions, Intravenous Drug use, etc. should be avoided. If you do not understand how these disease are transmitted, ask your travel-health care provider to explain it further. Blood Clots during Airplane flights - Prolonged sitting in airplanes increases the risk of blood clots in your legs. Some risk factors for blood clots include; A personal or family history of blood clots or a blood clotting disorder. Major surgery, significant trauma, or prolonged immobilization, includes a limb cast, in the last 6 weeks Cancer within the last 2 years or currently receiving chemotherapy Late pregnancy or the first 6 weeks after childbirth Estrogen-containing medication taken for oral contraception, female hormone replacement therapy (HRT), or antiestrogen therapy, such as Tamoxifen. Age greater than 50 years Severe obesity Congestive heart failure or recent heart attack Chronic venous insufficiency or large varicose veins You can reduce your risk of blood clots by keeping yourself well hydrated with non-alcoholic beverages during travel. Leg muscles provide a pumping action to help keep blood flowing. Walking around the cabin periodically, flexing your leg muscles in your seat and occasionally changing positions will help decrease your risk. If you have a high-risk condition, you may need compression stockings or aspirin to help avoid blood clots. First Aid/Sterile Needle Kits – In some parts of the world sterile needle may not be available for emergency injections, sterile wound closure or intravenous infusions of medications. Sterile medical kits are available. You can locate suppliers by searching terms like “sterile needles,” “travel,” “medical kit,” etc. with any internet search engine. Here are some websites that we have found using a similar search strategy: coastlineadventures.com traveldoctor.co.uk chinookmed.com survivalsuppliers.com medexassist.com www.masta.org safetycentral.com adventuremedicalkits.com www.safetravel.com preparedness.com traveldoctoronline.net healthytraveler.com Thank you for choosing Infectious Disease Specialists Travel Medicine Clinic. We hope that you have a safe and enjoyable trip. 2